I didn't get residency last year

'Oh God! I didn't match.' I was terribly upset upon seeing the email from National Residency Matching Program (NRMP) last year. I could not sleep that night. The whole year was like a painful dream for me. Death of Grand mother by advanced Pancreatic cancer, sickening problem in relation, bad numbers of interview calls, all had a cumulative effect on my overall well being.



I tried to dig into the possible reasons behind the fewer interview calls last year. My friends had at least 5 interview calls in that season. One of my friends had overwhelming 23 calls, out of which he attended 20 calls that winter and finally landing in one of the best residency programs.

Here are few noteworthy reasons which might have played certain role in delaying my timeline in getting the American dreams of residency in Internal medicine:

1. Delayed Educational Commission for Foreign Medical Graduate (ECFMG) Certification.
I was  ECFMG Certified on January, far later than the time for usual application submission date i.e; September 1. Though I passed my Step II CS in October, I didn't get it until January. It is because my diploma was not issued until November of the last year.

2. Delayed Diploma Certificate Issuance.

I could not apply for my early issuance of diploma. It is because I went to Scandinavia for 3 months of exchange program. Unfortunately, Department of Medical education who send us to the Scandinavia for the Scholarship exchange program didn't give privilege for our exchange program to be counted in our normal academic timeline. So we needed to repeat the Internship of 3 months duration in various departments. It increases our duration of Internship by 3 months.


3. Surplus use of time
I had 15 days of good preparation before flying to Scandinavia from department of medicine. Despite knowing the fact that I needed to repeat the posting I took the leave. Similarly, I delayed resuming my posting for 15 days in the department of Surgery after my exchange program was over. I wanted everything to be in slow pace.

4. Working in Home
I didn't make my mind to take USMLE for my career option then. So I decided to take a house officer job for at least 6 months at my home place. I immediately upon finishing my Internship went to village for the Medical officer job. With all those hectic schedules and busy hours, and working environment and attitudes of all people whom I worked with, forced me to rethink about my career options and opportunities. USMLE was the best option as well as opportunity. At last I made my decision to give it a try so I decided to quit the job and kneel down for exam. I was 8 months late already in the line.


5. Late Exam Taker
I took my Step II CS exam in second week of August. My result was released on October with the group who took theirs after July 12 that year. Therefore I could not apply to the programs on September 1 with completed application. I just had Step I and Step II CK results at hand.

6. Lack of Proper Interview Preparation
If senior recommends to the program director one has higher chance of being selected either through prematch procedure or rank order lists. I heard it everywhere. ' In America its who you know is important than what you know' a program director told to one of my colleagues during the time of interview. He shared his experience to me to soothe my uncertain soul. Upon hearing his thoughts and experiences I was somehow excited and more uncertain at the same time about the probability of getting the one. Since the first interview where I wanted to join and senior belonged, I almost quitted interview preparation. The final result is obvious. I still don't know what is interview and how to effectively tackle it? Those might have greater effect than predicted consequence in the Match result, I guess.

7. Bad Rank Order List
I just had an idea that after interviews we need to prepare rank order lists of the programs in order of our preferences and so do the programs, of the candidates in order of their perferences. On the day of match the R3 electronic system of NRMP tries to matches the program and the candidate. So this whole matching thing works. As for my match rank order list I put the program in which I always wanted to be in regardless of it reputation and the rank, and other high ranking programs in low order rank. I am less than sure but this may be another factor for my unmatching last year.

8. Immediate  return to home
I was among others not to have any permanet and persistent floor to share in USA. I moved to four different places for mere temporay lodging. I have used my time, money and energy to think for the next place for stay, rather than using those precious energy to think for sure ways to get into observerships or residency at large. It was really a struggle for me during those 6 months of stay in US. Had I stayed in USA after the interview season I could have managed to study for step III examination or took exam so that I could send the result to the programs where I gave interviews. It would be another added credential for the process of raking. But what happened can not be changed.

9. Absence of US clinical experiences: Observership/ Externship
Due to lack of time I could not make time to apply for and gain clinical experience in US clinical settings. Though program directors and the homepages of the many programs do not acknowledge the observership as  US clinical experience, doing observership shows ones' motivation and determination in pursuing US graduate medical education. I failed at this point too.